Questions and Answers
What percentage of children have one or more allergic disorders?
What is a risk factor for allergic disorders in children?
What is the name of the hypothesis that suggests a link between modern living and allergic disorders?
What type of immune system disorder can result in autoimmune diseases?
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What is the type of allergic reaction that occurs within minutes of exposure?
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What is a symptom of the early phase of an IgE mediated allergic reaction?
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What is a characteristic of non-IgE mediated allergic reactions?
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What percentage of children have food allergy?
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What is the common cause of food allergy in infants?
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What is the time frame for IgE-mediated food allergy to occur after ingestion?
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What is a characteristic symptom of non-IgE-mediated food allergy?
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What is the term for a non-immunological reaction to a specific food?
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What is the primary step in managing food allergy?
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What is a common cause of IgE-mediated food allergy in older children?
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What is a confirmatory test for IgE-mediated food allergy?
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What is a characteristic symptom of anaphylaxis?
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Which symptom is associated with mouth breathing in allergic conditions?
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What does a negative skin prick test suggest?
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Which of the following is a common symptom associated with allergic rhinitis?
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What is a probable benefit of feeding common food allergens to infants?
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Which investigation is used to test for inhaled allergens and other allergy types?
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What may indicate the presence of Dennie–Morgan folds in a child?
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Which of the following age groups typically experiences allergic rhinitis?
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What common investigation may occur if a child is thought to have outgrown an allergy?
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What is the recommended treatment for mild allergic reactions, such as rash or swelling?
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Which of the following is NOT a common cause of food allergy?
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How is an IgE-mediated food allergy typically diagnosed?
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What is the primary goal of immunotherapy for food allergies?
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Which of these food allergies tends to persist into adulthood?
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What is the recommended action for individuals at risk of severe allergic reactions?
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Study Notes
Allergic Disorders in Children
- Up to 40% of children experience allergic disorders, including eczema, allergic rhinitis, and asthma.
- Approximately 6% of children suffer from food allergies, with an increasing prevalence observed.
Risk Factors
- Lower risk of allergies found in children from larger families or those raised on farms, linked to altered microbial exposure.
- Hygiene hypothesis suggests modern living contributes to increased allergy rates.
Immune System Abnormalities
- Abnormal immune responses can lead to:
- Allergic diseases
- Autoimmune disorders, such as type I diabetes mellitus and systemic lupus erythematosus
- Immunodeficiency
Types of Allergic Reactions
-
IgE Mediated:
- Severe reactions usually occur rapidly (minutes) due to histamine release from mast cells.
- Symptoms include urticaria, angioedema, sneezing, vomiting, bronchospasm, and potential cardiovascular shock.
- A late-phase response occurs within 4–6 hours, presenting as nasal congestion and bronchospasm.
-
Non-IgE Mediated:
- Symptoms manifest later and may include gastrointestinal issues.
Clinical Examination
- An allergy-focused history is crucial for accurate diagnosis.
- Indicators include:
- Mouth breathing, allergic salute, nasal crease
- Pale and swollen inferior nasal turbinates
- Hyperinflated chest or Harrison sulci
- Atopic eczema and allergic conjunctivitis
- Growth faltering and Dennie-Morgan folds
Age-Related Allergic Disorders
- Eczema and food allergies prevalent in infancy.
- Allergic rhinitis, conjunctivitis, and asthma common in preschool and primary school-aged children.
- Coexistence of multiple allergic disorders is common.
Diagnostic Investigations
-
Skin Prick Testing:
- Used for food, inhaled allergens, and drug allergies; positive results indicated by wheals of 4 mm or greater.
-
Other Tests:
- Raised total IgE and specific IgE levels indicate atopy.
- Allergen challenges may clarify ambiguous cases.
- Spirometry and lung function tests assess respiratory issues.
Prevention Strategies
- Immune tolerance may be promoted by early feeding of common allergens.
- House dust avoidance is recommended for children with asthma.
- Probiotics, nutritional supplements, and some medications have not been effective.
Food Allergies Overview
- Common allergens in infants include cow’s milk, eggs, and nuts; in older children, peanuts, fish, and shellfish are prevalent.
IgE-Mediated Food Allergy
- Symptoms appear within 10–120 minutes of ingesting the allergen, including urticaria, facial swelling, and anaphylaxis.
Non-IgE-Mediated Food Allergy
- Symptoms manifest hours after ingestion and often involve gastrointestinal tract issues, such as diarrhea and vomiting.
Food Intolerance
- Defined as a non-immunological reaction to specific food items (e.g., lactose intolerance).
Diagnosis of Food Allergies
- Clinical history combined with skin prick tests and specific IgE antibodies helps confirm IgE-mediated food allergies.
Management of Food Allergies
- Avoidance of the allergenic food is imperative.
- Processed foods may mitigate reactions to some proteins.
- Patients should have a written self-management plan for allergy management.
Reaction Management
- For mild reactions, non-sedating antihistamines are recommended.
- Severe reactions demand immediate treatment with intramuscular adrenaline (EpiPen), which must be carried at all times.
Immunotherapy
- Involves gradual exposure to minimal amounts of the allergen, building up tolerance over time.
Prognosis
- Cow's milk and egg allergies often resolve in early childhood, while nut and seafood allergies tend to persist into adulthood.
- Excessive caution regarding dietary restrictions can significantly affect family life.
Summary
- Food allergies affect about 6% of children, commonly triggered by egg, milk, nuts, seafood, wheat, legumes, seeds, and fruits.
- Diagnosis relies on clinical history and skin prick tests or specific IgE antibodies.
- Children at risk of severe reactions should always carry an adrenaline autoinjector.
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Description
This quiz covers allergic disorders in children, including eczema, allergic rhinitis, and asthma, as well as risk factors and immune system abnormalities. Learn about the prevalence and hygienic influences on allergies in kids.
